Microdosing (Low Dose) Testosterone HRT

For folx seeking subtle, slower changes on testosterone, microdosing is a wonderful option.

An illustration of a gel pump bottle and a syringe.

Illustration by Leo Mateus.

In the sea of gender identities and expression, a lot of folx live somewhere on the great spectrum beyond male and female. Nonbinary, gender nonconforming (GNC), genderqueer, X-gender, transgender experiences within or beyond the binary can entail exploring bodily changes in all different ways.

Many along the gender spectrum may be considering taking or are currently taking testosterone HRT as a tool for their body to reflect their truest self. With testosterone HRT, folx can expect changes such as facial and body hair growth or a deeper voice, along with other shifts, depending on the person. More and more now, we’re seeing folx who are interested in subtle changes, or those who want to ease into changes to slowly see how they feel, opting for microdosing testosterone.

Microdosing is a tool for more subtle or slower changes.

Microdosing or low-dose HRT has become a tool for many trans, nonbinary, and GNC people. In fact, The World Professional Association for Transgender Health (WPATH) now includes nonbinary identities and the need for personalized approaches in their Standards of Care.

Some folx consider microdosing when they want certain effects of HRT but not others. While it is hard to know for sure in advance exactly how changes will happen with HRT, we can work with folx to try to achieve the best outcome with the tools we have.

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Compared to standard doses of testosterone, these lower doses are often half that amount. This allows the physical changes to develop slowly and over a longer period of time. Some folx will use HRT for a short time to achieve certain effects, such as facial and body hair growth and voice changes, then will discontinue before further effects take place. 

Those pursuing “masculine” features can explore low-dose testosterone. One aspect of low-dose testosterone that may be bothersome to some is that it probably will not stop monthly bleeding. Bleeding can be stopped if desired with higher doses of T, medications also known as birth control, or surgeries like uterine ablation (removes uterine lining) or hysterectomy (removes uterus with or without other related organs).

There are options two options to microdose testosterone with FOLX:

There are just as many ways to microdose as there are to typical dose, and the main difference is in the concentration of hormones taken. Typical low dose regimens are listed below, but lower doses can be tried if desired. 

Injectable Testosterone Testosterone Gel
Low Dose (Microdose) 0.1mL (20mg of 200mg/mL) weekly 20mg daily
Medium Low Dose (Microdose) 0.2mL (40mg) weekly
Average Dose .3mL (60mg) weekly 50mg daily
Maximum Dose 0.5mL (100mg) weekly or 1mL (200mg) biweekly 100mg daily

For those curious about how other nonbinary and GNC folx have approached microdosing and low-dose HRT, there are a few great anecdotes in recent years. In this piece by Them, NB/GNC folx talk about their medical transition, costs, and hurdles they face in the current medical system. And in this article from Vice, we get a more personal look.

For those ready to get started with FOLX for microdosing testosterone, the process begins here. For existing FOLX members with questions about their dosage, don't hesitate to message or schedule time with a clinician. And for those who’ve just got some more questions, read up on testosterone here, and feel free to reach out to us at thelibrary@folxhealth.com.